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The problem, she says, is lack of funding. Health-care costs — from Pap smears to pathology labs — are skyrocketing. The cost of contraceptives has also risen sharply, particularly for newer, longer-lasting methods with lower failure rates. Plus, Title X money is now being spent on a broader range of services, such as STD testing. Meanwhile, President Bush's appropriations for the program have stagnated. Title X's annual budget is $283 million; if it had kept pace with inflation, that number would be $693 million. But instead of increasing funding, the Bush administration is funneling money to abstinence-only education, which doesn't provide information on contraception — or health care.
The result: in addition to the poor and the regionally isolated, teenagers and young women are affected. (It's estimated that thirty percent of federally funded family-planning recipients are younger than twenty, and fifty percent are twenty to twenty-nine.) As more people lose their insurance, they turn to clinics. Yet clinics don't get more money for serving more patients. "It doesn't matter if you serve one or 1,000 patients, you get the same amount of money from Title X," says Jodie Curtis, assistant director for government relations for PPFA. "It's not like Medicaid, where you get reimbursed per patient." Many PPFA health centers even provide primary-care services, such as diabetes testing, and provide referrals to specialized health care."We really are the entry point for broader health care," adds Curtis. "If people aren't coming in to see us, chances are, they aren't coming in for health care at all," she adds.
Ultimately, less money means more miscommunication. |
Although, in the words of Danielle Tierney, a spokesperson for PPFA's Austin affiliate, "Planned Parenthood is a health-care provider, first and foremost," the
organization has also fought important reproductive-health battles, such as a woman's right to an abortion, over-the-counter availability of Plan B, and teenagers' access to birth control. "The wonderful day should come at some point when all of our concerns would be about providing the best quality of care, not fighting people who want to eliminate family-planning programs," says Feldt.
That day seems far in the future. The Senate just passed a $38 billion deficit reduction that dramatically cuts Medicaid and Medicare services. According to The New York Times, thirteen million low-income people face new or higher co-payments for medical services. More than 100,000 will lose health-care coverage altogether. Federally funded health clinics will have to pick up the slack. ("We now know who is sacrificing in order to help pay for the war in Iraq: the poor and their children," read a Mercury News editorial on February 1st.)
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